Encephalitis due to Epstein-Barr virus

Bhatti, N.; Larson, Elise; Hickey, Mark; Seal, D.V.

doi:10.1016/s0163-4453(90)92412-e

Cited by 29 publications

(14 citation statements)

References 9 publications

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“…Ganciclovir and, to a lesser extent, acyclovir have good in vitro activity against Epstein-Barr virus and can be of benefit in selected cases, particularly when direct invasion of the brain is documented. [34][35][36] Corticosteroids have been used in acute disseminated encephalomyelitis and other immunologically mediated disease entities of the central nervous system, as well as with fulminant infectious mononucleosis. 36 One of two children in our cohort who suffered a relapse appeared to respond favorably to corticosteroid therapy, a finding that has been noted by others.…”

Section: Discussionmentioning

confidence: 99%

Pediatric Epstein-Barr Virus—Associated Encephalitis: 10-Year Review

et al. 2006

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Many neurologic manifestations of Epstein-Barr virus (EBV) infection have been documented, including encephalitis, aseptic meningitis, transverse myelitis, and Guillain-Barré syndrome. These manifestations can occur alone or coincidentally with the clinical picture of infectious mononucleosis. Since 1994, The Hospital for Sick Children has maintained a prospective registry of all children admitted with acute encephalitis. This report summarizes all cases of Epstein-Barr virus-associated encephalitis compiled from 1994 to 2003. Twenty-one (6%) of 216 children, median age 13 years (range 3-17 years), in the Encephalitis Registry were identified as having evidence of Epstein-Barr virus infection. This evidence consisted of convincing Epstein-Barr virus serology and/or positive cerebrospinal fluid polymerase chain reaction (PCR). One patient had symptoms of classic infectious mononucleosis; all others had a nonspecific prodrome, including fever (n = 17; 81%) and headache (n = 14; 66%). Slightly less than half (n = 10; 48%) had seizures and often had electroencephalograms showing a slow background (n = 12; 57%). Many demonstrated cerebrospinal fluid pleocytosis (n = 17; 81%), and 71% (n = 15) had abnormal magnetic resonance imaging findings. Two patients died, 2 suffered mild deficits, and 16 were neurologically normal at follow-up. Most patients with Epstein-Barr virus encephalitis do not show typical symptoms of infectious mononucleosis. Establishing a diagnosis of Epstein-Barr virus encephalitis can be difficult, and, consequently, a combination of serologic and molecular techniques should be used when investigating a child with acute encephalitis. Most children make full recoveries, but residual neurologic sequelae and even death can and do occur.

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Section: Discussionmentioning

confidence: 99%

Pediatric Epstein-Barr Virus—Associated Encephalitis: 10-Year Review

et al. 2006

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“…Epstein-Barr virus (EBV) encephalitis is infrequently reported [1] and the brain magnetic resonance (MR) findings of EBV infection are occasionally reported [2][3][4]. We have had the opportunity to review MR scans of 29 patients with the diagnosis of EBV encephalitis or encephalomyelitis.…”

Section: Introdutionmentioning

confidence: 99%

Epstein-Barr virus encephalitis and encephalomyelitis: MR findings

Shian

1996

Pediatr Radiol

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The purpose of this project is to investigate the clinical and brain MR characteristics of Epstein-Barr virus (EBV) encephalitis and encephalomyelitis. Clinical and 30 MR findings of 29 patients with EBV encephalitis or encephalomyelitis were retrospectively reviewed. Patients included 24 with encephalitis, 3 with encephalomyelitis, and 2 with brain-stem encephalitis. Altered consciousness, seizures, visual hallucination, and acute psychotic reaction were the common presentations. Eight patients had positive MR findings. These included T2 prolongation over gray and white matter, periventricular leukomalacia, and brain atrophy. Transient T2 prolongation over gray and white matter was found in one patient. Our results indicate that EBV encephalitis and encephalomyelitis have a wide range of both clinical and MR findings. The MR lesions may disappear in a short period, so the timing for the MR scan may be critical.

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“…To date, ataxia secondary to either mononucleosis or postinfection syndrome has been largely identified in pediatric case reports [1, 2, 4, 5]. It is a rare symptomatology in young adults, especially in the context of a clinical picture including symptoms of an acute, likely primary, viral encephalitis [3, 7]. The differential for acute ataxia in this population includes cerebellar abscess, head trauma, vertebrobasilar dissection, alcohol toxicity, tick paralysis, seizure, and acute demyelinating encephalomyelitis.…”

Section: Discussionmentioning

confidence: 99%

Ataxia and Encephalitis in a Young Adult with EBV Mononucleosis: A Case Report

Hussain

Hussain²

2013

Case Reports in Neurological Medicine

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Neurological manifestations of mononucleosis are extremely rare, occurring in about 1% of all cases. However, when they occur, appropriate treatment must be undertaken to ensure appropriate symptomatic management and reduce morbidity. We present the case of a 25-year-old graduate student with weeklong complaints of fever, sore throat, fatigue, nausea, and “dizziness.” She later developed increased sleep requirements, ataxia, vertigo, and nystagmus with a positive EBV IgM titer confirming acute infectious mononucleosis. The patient was clinically diagnosed with EBV-associated cerebellitis and encephalitis, displaying neurological and psychiatric impairment commonly seen in postconcussion syndrome. MRI showed no acute changes. She was started on valacyclovir and a prednisone taper, recovering by the end of twelve weeks. Though corticosteroids and acyclovir are not recommended therapy in patients presenting with EBV-associated ataxia, clinicians may want to keep a low threshold to start these medications in case more serious neurological sequelae develop.

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Encephalitis due to Epstein-Barr virus

Cited by 29 publications

References 9 publications

Pediatric Epstein-Barr Virus—Associated Encephalitis: 10-Year Review

Pediatric Epstein-Barr Virus—Associated Encephalitis: 10-Year Review

Epstein-Barr virus encephalitis and encephalomyelitis: MR findings

Ataxia and Encephalitis in a Young Adult with EBV Mononucleosis: A Case Report

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